Motivating Quit Attempts Through Gamification: A Systematic Review of Digital Game-Based Interventions for Smoking Cessation.

Abstract

Tobacco use remains a leading cause of preventable disease and death worldwide. While quitting significantly reduces health risks, many individuals struggle to quit using traditional methods. With increasing access to mobile technology, gamified digital interventions have emerged as a novel approach to support smoking cessation. The aim of the review was to evaluate the effectiveness of gamification-based digital interventions in promoting smoking cessation, focusing on user engagement, abstinence rates, motivation, and implementation challenges. A systematic literature review was conducted using PubMed, Scopus, and Web of Science, guided by the population/patient/problem, intervention, comparison, and outcome (PICO) framework, to identify English-language articles published between January 2015 and July 2025 on gamified digital interventions for smoking cessation. A total of 136 articles were initially retrieved, out of which eight met all eligibility criteria and were included in the final review. Study selection followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and data extraction was done independently by two reviewers. The quality of included studies was assessed using the National Institutes of Health (NIH) tool checklist for controlled intervention studies. Out of 136 articles, eight met the inclusion criteria and were reviewed in depth. The studies highlighted five key areas: user engagement, quit rates, motivation, user satisfaction, and implementation challenges. Gamified tools, like virtual pets, leaderboards, and challenges, boosted engagement and motivation but didn't always lead to higher quit rates. Some apps, like SCAMPI and QuitIT, showed promising results, while others had mixed outcomes. Gamification can make quit-smoking apps more fun and motivating, helping people stay engaged and confident in their quit attempts. However, most studies showed only short-term benefits, and the evidence for long-term quitting is still weak.